Health

Cervical cancer control - Rhode Island

Article Abstract:

Cases of cancer of the uterus in Rhode Island during 1987 are reviewed. During this period there were 49 cases of invasive cervical cancer which resulted in 14 deaths. Progression of cervical cancer to an invasive stage and to eventual death can be prevented. Factors leading to death in these cases were: lack of screening with Pap tests; too long an interval between screenings; false negative screening results, i.e. the test showed no cancer when it was in fact present; rapid development of the condition between screenings; and positive test findings that were not properly followed-up. A telephone survey was carried out within the state on women over the age of 18 and under 40 and women over the age of 40. The data showed that 87 percent of women 20-39 had been screened within the previous three years, compared with 76 percent of woman 40 to 60. In the younger group, 13 percent had either never been screened or had not been screened in the prior 3 years. For the older population, only 4 percent had never been screened, but 20 percent had not been screened in the last three years. Of the younger women, two thirds had been negative on Pap smear screening, while 18 percent of this population had received a positive test, but had delayed therapy. The risk for cervical carcinoma is age related, and older woman who are at increased risk of the disease are also more likely to forego screening. PAP smears are generally considered to be the most effective means of detecting cervical abnormalities and cancer. Early detection and appropriate treatment are also related with decreased morbidity and improved chances of survival.

Publisher:American Medical AssociationPublication Name:JAMA, The Journal of the American Medical AssociationSubject:HealthISSN:0098-7484Year:1989

Cancer of the cervix of the uterus was the cause of approximately 3 percent of all female deaths in the United States during the period of 1984-86. During this period the average yearly number of deaths attributable to cervical cancer was 4,543, and the disease was the 11th most frequent cause of death among women. The rate of occurrence is strongly related to increasing age, as 53 percent of these deaths occurred in women over the age of 60. When the statistical data is adjusted for the effect of age, black women are 2.8 times more frequently affected by cervical cancer. The rate of occurrence was also found to vary regionally, with the highest level in urban areas of the northeast and the lowest levels in rural Utah. The survival rate of women with the disease at five years was 67 percent, although patients with advanced disease had lower survival rates. The risk of this cancer is also related to the number of sexual contacts and to the age of first intercourse. These statistics and other data point to a possible cause by the papillomavirus, which is spread in part by sexual contact. The use of barriers (e.g., condoms) and spermicides, socioeconomic status, and smoking are also factors affecting risk. Twenty-nine percent of the deaths in cervical carcinoma are related to cigarette smoking. Prevention and increased survival of those afflicted depend upon early detection by PAP smears. The American Cancer Society now recommends that women begin receiving PAP smears as soon as they become sexually active.

Publisher:American Medical AssociationPublication Name:JAMA, The Journal of the American Medical AssociationSubject:HealthISSN:0098-7484Year:1989